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Immunotherapy (Allergy Shots)

Immunotherapy, or allergen allergy shots, can lead to long lasting relief from allergy symptoms, even after treatment is stopped.  Allergy shots are proven effective in treating allergic rhinitis, allergic asthma, stinging insect allergies, atopic dermatitis (eczema) and other allergic diseases that involve airborne allergens.  Allergy Shots may play a preventive role in pediatric allergic disease, preventing the  development of asthma and new allergies.  Adverse reactions to allergy shots are rare but do require immediate medical attention. This is why allergy shots should be administered in an appropriate facility, such as an allergists office.

What is Immunotherapy?

Immunotherapy, or allergen allergy shots, is a form of systematic desensitization.     Allergen allergy shots involves injecting increasing amounts of an allergen to a patient over several months, in a controlled setting.  With time, your bodies allergic reactions begin to diminish and your allergic reactions decrease in severity and sometimes, will subside completely. 

Who should be treated with allergy shots?

Allergy Shots are usually recommended for allergy patients who suffer from asthma, allergic rhinitis conjunctivitis, and stinging insect allergy. Because allergy immunotherapy may involve a significant time commitment, the decision to begin allergy immunotherapy should be made in conjunction with your allergist and may be based on several factors including the length of the allergy season, the severity of your symptoms, the ability to control your allergies with medications or environmental controls.

Is immunotherapy safe in children?

Recent evidence supports the use of allergy shots to prevent asthma in children.  Evidence also suggests that immunotherapy can prevent the development of new allergies in children as well.  Because very young children may have trouble cooperating with a program of allergy shots, allergy shots are not recommended for children under the age of five.   

How do allergy shots work?

If you are allergic to pollen, repeated and increasing exposure to pollen will usually worsen your symptoms.  So how can a series of injections that include the trigger of your allergy symptoms cause your allergy symptoms to decrease? Allergen immunotherapy works like much the same way a vaccinations. By gradually increasing the dose of the allergen in your allergy shot program, your body begins to develop a tolerance to to the allergen(s).
Your immunotherapy program will generally include two phases; the build-up phase and the maintenance phase.

  1. Build-up phase: This phase usually lasts from three to six months and requires that you receive injections 1 to 2 times per week.  Please understand that your scheduled program will depend on what your allergist thinks is the best program for you.  More rapid build up programs are sometimes recommended.  Most patients begin to experience an abatement of symptoms during the build-up phase. 
  2. Maintenance phase: This phase begins once the effective therapy dose is reached. Effective maintenance is different for each person. It depends on how ‘allergic they are' to their allergen and their responses during the allergy shots build-up phase. Once the maintenance dose is reached, the intervals between maintenance allergy shots generally ranges from every 2 to every 4 weeks. Your allergist will decide what range is best for you.

While improvement of symptoms can begin as early as the build up phase of allergy shot treatment, long term effects begin to manifest once a patient is on maintenance therapy.

When should allergy shots be stopped?

For maximum, long term relief of allergy symptoms, the maintenance phase of immunotherpay may be continued for several years. Many patients continue to remain allergy symptom free following the discontinuation of allergy shots.   A return of allergy symptoms may be due to the development of new allergies.  If your symptoms begin to worsen after discontinuing allergy shots, you will need to see your allergist to discover the reason. 

What are the side effects of allergy shots?

There two possible adverse reactions to immunotherapy.

Local reactions:
You may experience a local redness, itch or swelling, much like a mosquito bit, at the site of injection.  This usually occurs within twenty minutes and should not take longer than thirty minutes to abate. 

Systemic reactions:
This type of reaction, sometimes called anaphylaxis, is extremely rare. When a systemic reaction occurs it may begin with sneezing, nasal congestion or hives.  When severe anaphylaxis occurs, these symptoms may progress and include swelling in the throat, wheezing, chest tightness, nausea, dizziness or other symptoms. 
Most serious systemic reactions will occur within 20 minutes of receiving an immunotherapy injection.  Therefore, it is recommended that all patients remain under observation in the allergist office for this length of time following the administration of an allergy injection. 

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